Rapid-onset Primary Biliary Cirrhosis Resembling Drug-induced Liver Injury

• Published in: Internal Medicine Vol. 44; no. 10; pp. 1051 - 1054
• Main Authors: SOHDA, Tetsuro, SHIGA, Hiroshi, NAKANE, Hidetoshi, NISHIZAWA, Shinya, YOSHIKANE, Makoto, ANAN, Akira, SUZUKI, Norihisa, IRIE, Makoto, IWATA, Kaoru, WATANABE, Hiroshi, SAKISAKA, Shotaro
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.10.2005; Japanese Society of Internal Medicine
• Subjects: Biological and medical sciences; Chemical and Drug Induced Liver Injury - diagnosis; Diagnosis, Differential; diet product; Dietary Supplements - adverse effects; drug-induced liver injury; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Liver Cirrhosis, Biliary - diagnosis; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Middle Aged; Other diseases. Semiology; overlap syndrome; Plant Preparations; primary biliary liver cirrhosis (PBC); rapid onset; Time Factors; Drug; drug- induced liver injury; Primary biliary cirrhosis; diet product; overlap syndrome; Internal medicine; Nutrition; Hepatic disease; Overlap; Syndrome; rapid onset; Age of onset; Diet; primary biliary liver cirrhosis (PBC); Digestive diseases; Lesion
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.44.1051

A 54-year-old woman was admitted to our hospital because of acute liver injury. Since she had a history of having used a diet product, drug-induced liver injury (DILI) was initially considered. However, the patient was subsequently diagnosed as suffering from primary biliary cirrhosis (PBC) based on the findings of liver histology and serum anti-mitochondrial antibody positivity. Overlap syndrome between PBC and autoimmune hepatitis (AIH) was also suspected, however, serum levels of aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase became normal three months later, after treatment with combination therapy comprising ursodeoxycholic acid plus bezafibrate. We therefore concluded that the liver disease in this patient was actually PBC, but that it resembled overlap syndrome or DILI. In cases of PBC, a rapid onset, as frequently seen in the case of DILI, viral hepatitis or AIH, is not common. We herein report a rare case of PBC which resembled DILI.